Fortunately for her and for asthma sufferers everywhere, the then 13-year-old girl’s father happened to be George Maison, president of Riker Laboratories, now part of 3M Pharmaceuticals. Rather than dismissing the suggestion, he took the idea and charged his company’s pharmaceutical development laboratory with trying to find an answer.

The result was the pressurised metered-dose inhaler (pMDI), said to have taken less than two years to take from concept to clinical use – a mere blink of the eye compared with modern research and development periods.

Prof Andrew Bush and Dr Louise Fleming of Imperial College, London, also warned of potential side-effects including adrenal failure, and a risk of respiratory infections in adults.

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The finger of blame seemed to be pointing at GPs, although Bush and Fleming acknowledge that the lack of an objective test makes things difficult for doctors trying to make a diagnosis.

So it is unsurprising that family doctors have led the fightback against the “fashion accessory” label. Dr Imran Rafi, chair of clinical innovation and research at the Royal College of General Practitioners, said the label was “completely unhelpful with respect to the importance of inhalers in managing asthma”.

Dr Khetan Bhatt, a GP at a Hertfordshire practice with about 700 asthma sufferers, said: “The difficulty we get is getting people to take inhalers rather than people wanting to have inhalers. Children at a young age do not take it seriously.”

Bush and Fleming said the word “wheeze, the hallmark symptom of asthma, is used imprecisely by parents and professionals”. Stories of children being prescribed inhalers when they do not have asthma are not difficult to find on parenting forums. In the absence of an objective test, Rafi said, inhalers can be issued without certainty of an asthma diagnosis.

“It’s sometimes difficult making a diagnosis because of the fact that the symptoms overlap with many different types of conditions,” he said. “A viral, irritating cough can persist for a number of weeks. We wouldn’t put children on medication unless we really feel it’s necessary. Sometimes we have to use the blue [reliever] inhaler as a trial but ask the parents to monitor the peak flow (lung capacity) and we can use that as a diagnosis later. There’s no one single definitive test.”

He stressed that a clear management plan was essential to ensure the child was not taking something unnecessarily over a prolonged period.

For all the benefits that inhalers have brought over the decades, this is not the first time they been stigmatised. After their introduction in 1956, inhalers and the medicine they contained at the time, isoprenaline, were linked to an asthma epidemic in the 1960s.

A 400% increase in deaths from asthma in the five- to 34-years age group coincided with a 600% increase in prescription and sales of inhalers containing isoprenaline. In an article for the Primary Care Respiratory Journal, Graham Compton wrote that as a result “both clinicians and patients considered pMDIs to be dangerous”.

It was not long before salbutamol (marketed as Ventolin) replaced isoprenaline as the primary medicine used in inhalers for relief of asthma symptoms, and it remains so today.

If salbutamol was one breakthrough, the later introduction of steroid inhalers (which are brown, as opposed to the blue reliever puffers), which prevent symptoms rather than relieve them, was even more significant.

Dr Francis Gilchrist, trustee of the British Lung Foundation, said: “The inhaled steroids have absolutely revolutionised asthma care. Previously steroid tablets were the mainstay of treatment, which had more side-effects including restricted growth. The idea [with inhalers] is that you’re breathing the medicine directly into the lungs, only a small proportion is absorbed into the blood and so there are fewer side-effects.”

Steroid inhalers are considered the most effective medications for controlling asthma when taken regularly and can reduce the need for the blue puffer over time.

Given the importance of the device, Gilchrist, a paediatric respiratory consultant, is concerned that people will take the wrong message from the “fashion accessory” description.

“There is the possibility that inhalers are given to children who do not need them,” he said. “But the reverse needs to be made clear, that if inhalers are not given to children who do have asthma, they are at risk of dying from an asthma attack.

“There are side-effects associated with inhaled steroids, which are the most commonly prescribed preventative treatment, but if standard doses are used these are usually mild.”

For his part, Bush admitted his language may have been “facetious”. He said that for patients with mild to moderate asthma, steroid inhalers had been “life-transforming”. But he could not resist another unflattering comparison.

“Instead of being seen as an important piece of equipment that can be life-saving,” he said, “like a handbag, everyone’s got one.”

The inhaler – a profile

Born: 1956 in the US.

Career: On its introduction, replaced the cumbersome squeeze-bulb glass nebuliser. Initially held medicine used to relieve symptoms but later also used (separately) to issue preventive medicine.

They say: “Dispensed for no good reason, and have become almost a fashion accessory” (Prof Andrew Bush and Dr Louise Fleming). “Inhaled steroids have absolutely revolutionised asthma care” (Dr Francis Gilchrist).

High point: Replacing steroid tablets, which had higher risk of serious side-effects such as growth suppression. With inhalers the medicine is breathed directly into the lungs, only a small proportion is absorbed into the blood and so there are fewer side-effects.

Low point: Shortly after their introduction, when they contained a medicine called isoprenaline, their use was linked to the asthma epidemic of the 1960s.